Paramedic Application of a Triage Sieve: A Paper-Based Exercise

Area of Science:

• Emergency Medicine
• Disaster Management
• Paramedic Education

Background:

• Triage is crucial for prioritizing casualties during mass-casualty incidents (MCIs) when resources are limited.
• Measuring the accuracy of triage sieve application is essential for improving emergency response.
• Current methods for assessing triage accuracy require further development and validation.

Purpose of the Study:

• To evaluate the impact of theoretical knowledge and practical aide-memoir use on paramedic triage sieve accuracy.
• To quantify improvements in triage accuracy rates through specific interventions.
• To establish reliable measures for assessing triage sieve performance in MCIs.

Main Methods:

• 292 paramedics were randomly assigned to a control group or one of three intervention groups.
• Interventions included educational review sessions and/or an aide-memoir.
• Participants triaged 20 simulated casualties using a standardized questionnaire.

Main Results:

• The control group achieved a 47% correct triage accuracy rate.
• Aide-memoir use significantly increased correct triage accuracy to 90%, while educational review alone yielded 77%.
• Combined intervention resulted in 89% accuracy; over-triage rates did not differ significantly across groups.

Conclusions:

• An aide-memoir is highly effective in maximizing mass-casualty incident triage accuracy for paramedics.
• Just-in-time educational refreshers offer benefits but have operational limitations in MCI settings.
• The study provides a framework for measuring acceptable triage sieve performance during MCIs.